Individual
MABEL HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7737 N UNIVERSITY DR STE 107, TAMARAC, FL 33321-2968
(954) 720-0056
Mailing address
7737 N UNIVERSITY DR STE 107, TAMARAC, FL 33321-2968
(954) 720-0056
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME49255
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051555800
—
FL
Enumeration date
11/05/2009
Last updated
11/05/2009
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